What do you do if your open enrollment doesn't match your spouse's?

Mine’s in June, his is in December. This is now, for the second time, a huge problem.

This past year I put him on my insurance and we’ve regretted it ever since - frankly we did it a bit rashly, because his insurance paid for NOTHING but since then we’ve spent more than we would have spent just paying out of pocket for things. This is not working out for us. The only way he could get on my insurance (during my open enrollment in the summer) was that his company let him out, which I understand is not common.

Well, now his company is changing insurers and this new plan, at least on paper, looks really good! It would cut our insurance bill in half for him to switch back. Only thing is… yeah.

I asked my HR department and they said that unlike his employer they wouldn’t let him out mid-year. (You’d think they would want to, since they’re paying a portion.) So we need to find out if HIS company will put him back in June if I drop him. But probably not.

So what do people do about this crap? I mean, this is stupid. It’s ridiculous for this to be an issue - either go uninsured or pay for two plans at once, that’s just incredibly silly that we have to do this! What do other people do? Is there maybe some kind of catastrophic cheap-ass private 6 month plan we can get him?

(We are trying to have a Qualifying Life Event but that would be nine months in the future anyway.)

Will there be a problem getting him back on his? I know some companies have short term policies, I think Blue Cross Blue Shield is one, but I would probably just pay for two until he is back on his.

“Just”? It’s a lot of money.

Is a change in spouse’s coverage a “qualifying event” under your plans? My impression is that it typically is.

It is, but not necessarily a voluntary change. Simply requesting coverage be terminated will not be considered a qualifying event.

In short, you’re pretty much screwed. Voluntary termination from an employer sponsored plan is allowed by law, but the Plan (employer) may force you to continue to pay your contribution when those contributions are made pre-tax, as in direct from your paycheck. There’s a bunch of IRS issues with early termination that employers don’t want to deal with which is typically why they won’t allow contributions to cease.

What I mean by the above is participation in any employee benefit is always voluntary, but once you sign up, you’re usually locked in financially for that period.

Yes, as I understand it he could leave if we had a change forced on us (higher premiums, etc) but not if it’s our decision.

There’s always divorce. :smiley:

Don’t think we didn’t consider getting divorced and remarried, but that takes forever in South Carolina!

I checked with the wife, who is an HR outsourcing project manager and has a masters’ in employee benefits, a CEBS, and many other impressive acronyms I don’t understand. She said being added to another qualifying plan is a qualifying event under ERISA/Section 125.

Like RNATB said - normally, if someone adds you as a dependent on their plan, that’s a qualifying event to drop your own coverage. So you should be able to drop your plan when he adds you to his in his enrollment period.

But I would verify that with your plan administrator.

No, I’m not trying to get on his. Mine is free! I’m trying to get him off mine.

Right. If he picks up his employer’s coverage in June, he will be eligible to drop from your plan.

I know, but the risk of being uncovered and being in an accident or getting sick is worse.

In similar circumstances we paid the extra. My sister gambled went without for a couple of months, and it worked out well for her. No horror stories here at all.

He’d pick it up in December - and my HR department told me that does NOT make him eligible to drop my plan mid-year.

I think they are probably wrong about that. You might get a more useful answer directly from your insurance company’s help line.

I never understood this open enrollment thing. I had my own company, and got health insurance through that. I needed to start during ‘open enrollment’, I asked what that was, they basically said anytime I define it to be.

Sounds like if you can’t define your open enrollment you are living on someone else’s terms.

Why yes. Yes you are. That somebody else sends me lovely paychecks every two weeks; it’s called “employment”.

Wow sounds nice, do you get more then 5 days off on average per week to do the things you want? If so sounds like it’s for me. I can deal then with someone else deciding what ‘open enrollment’ is, especially if I can tell them first what to make it.


If it’s your company, you get to determine when open enrollment is. The OP doesn’t work for her own company.

Section 125 doesn’t apply to health plans. It only applies to cafeteria plans. ERISA is… sketchy here and generally doesn’t govern eligibility, enrollment, or terminations. That’s typically HIPAA.

ERISA may allow a voluntary termination, but IRS rules may force continued contribution. The net result is you’re terminated from the plan at your request, but you have to continue to pay for it because of pre-tax contribution rules/IRS. Not the best option there.